Medicare Part A (Hospital)

What is Medicare Part A (Hospital)?

DEFINITION of Medicare Part A, Hospital Insurance
One of the four components of the federal government’s health insurance program for senior citizens. Medicare Part A helps pay for bills related to hospital care, skilled nursing facility or nursing home care, hospice care and home health services. It covers expenses such as a semi-private room at a skilled nursing facility; inpatient care, supplies and drugs during a hospital stay; physical and occupational therapy in your home if you are homebound; and doctor’s services, medication and grief and loss counseling for terminally ill patients.

Medicare Part A covers many hospital-related services, but it doesn’t cover everything. Providers must ask patients to sign a notice in advance of receiving treatment when a service may not be covered. This procedure lets the patient choose whether to accept the service and plan to pay out of pocket or refuse the service. To be proactive about keeping your medical bills down, it’s a good idea to find out before using a Part A service if Medicare will cover all, part or none of the cost. If Medicare won’t cover enough of the expense, find out why. There may be an alternative that would still help you that is covered, or you can file an appeal to try to get the coverage decision changed in your favor.

The three reasons why Medicare Part A might not cover something are general federal and state laws, specific federal laws about what Medicare covers, and local Medicare claims processors’ assessment of whether a service is medically necessary. One example of a service Medicare does not usually cover is custodial care in a skilled nursing facility – help with basic activities like getting dressed, bathing and eating – if it’s the only care you need. You must have more serious needs for Medicare to cover your nursing home stay.